June 2003 Bulletin

From our readers

Write to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262

Diversity Award

While being highly appreciative of Dr. Wayne D. Southwick’s selection as the first recipient of the newly-established AAOS Diversity Award (February 2003 issue), I couldn’t help thinking that, all other criteria notwithstanding, a major consideration for the award—as is the case of the Nobel Prize—is that the nominee/recipient has to still be alive in order to be so honored. Were that not the case, I would have been extremely proud to have nominated Dr. Frank Stinchfield, a highly worthy (although now deceased) contemporary of Dr. Southwick for the AAOS Diversity Award.

During his 20-year tenure as director of the New York Orthopaedic Hospital (NYOH) and chief orthopaedic surgeon of Columbia University’s College of Physicians and Surgeons, Dr. Stinchfield was more than just an innovative surgeon, great teacher, consummate politician and true leader. In the arena of multicultural and gender relations, he was a genuinely caring human being and a true pioneer. Among Dr. Stinchfield’s accomplishments in this arena were:

The recruiting, in 1964, of Dr. Marvin L. Shelton, one of America’s first board-certified African-American orthopaedists and Columbia University’s first black orthopaedic attending. As the first black orthopaedic surgeon to gain admitting privileges at an Ivy League-affiliated hospital, Dr. Shelton also became the first Director of Orthopaedic Surgery at Harlem Hospital. Drs. Stinchfield and Shelton collaborated to establish a formalized Harlem Hospital rotation for NYOH residents and, subsequently, an independent Harlem Hospital based orthopaedic residency training program. One of the first NYOH residents to rotate through Harlem Hospital was Dr. Harold Dick, who later became and remained an active member of the Harlem Hospital attending staff, even after subsequently becoming Director of the NYOH.

The recruitment of Dr. Nas Eftekhar, a talented and highly trained joint implant surgeon, to his attending staff in the early 1970’s.

The selection, in 1971, of Dr. John Buckner as the NYOH’s and Columbia University’s first black orthopaedic resident; and subsequently, in 1976, of both Dr. William King and myself, who comprised 25 percent of that year’s entering resident roster.

Dr. Stinchfield formally retired as the director of the NYOH in 1976 but remained on as an active surgeon and highly influential member of the NYOH faculty for 13 additional years. Although he is no longer with us, his pioneering influence in introducing quality-oriented multicultural diversity into the New York orthopaedic arena certainly lives on. Perhaps the greatest testament to his ongoing influence and vision can be summed up as follows: In the 18 years following his formal retirement as director, the NYOH, under the subsequent leadership of Drs. Alexander Garcia (1976-84) and Harold Dick (1984-1998), admitted and trained more under- represented minorities, more Asian Americans, and more women than it had in its entire preceding 100-plus years of existence. These graduates have gone on to represent the highest ideals of orthopaedics in general and the NYOH in particular; many of them devote a significant part of their practice time to the care of under-represented minorities and under-insured patients.

As one of the first three African-Americans ever to train at the New York Orthopaedic Hospital, I can certainly attest that Dr. Stinchfield’s vision, even-handedness, leadership, and character were major reasons for my selecting that institution for my orthopaedic training. Now, many years later, I appreciate what he did and stood for even more. Although his death my have disqualified him from consideration for a Diversity Award, it does not diminish my recollection of how truly special he was. He was a major pioneering influence on multicultural medical education at Columbia, long before it was fashionable, laudable or the "politically correct" thing to do.

Shearwood J. McClelland, MD
New York, N.Y.

Affirmative Action

It is disappointing that the AAOS chose to support the affirmative action policies now being debated before the Supreme Court.

Increased minority representation in the medical profession and in orthopaedics is a desirable goal. However, this will not be achieved by affirmative action. Affirmative action, by definition, takes less-qualified applicants and places them into educational environments where their potential for success as students is (at best) marginal. The Texas, California and Florida experiences to date would suggest that, when students are properly enrolled in schools appropriate for their true academic abilities, they are much more likely to succeed. Unfortunately no one wishes to look objectively at the fate of affirmative action-admitted students for fear of proving the obvious.

There is not any evidence that students admitted under affirmative action become the doctors and orthopaedic surgeons the system desires to produce. There is, however, evidence that many of these students drop out because they cannot compete in the academic environment to which they have been inappropriately inserted primarily to satisfy someone’s concept of a diverse student body. Certainly, in our own medical school, there is a very strong correlation with current poor academic performance and previous admission criteria. The affirmative action policies also taint the successes of minorities with appropriate academic credentials and put the emphasis on quantity rather than quality.

I support the AAOS goal to increase the diversity of physicians in orthopaedic practice. However, the available evidence would suggest that affirmative action policies are not the way to achieve these goals.

Bob Vander Griend, MD
Associate Professor, Orthopaedics & Rehabilitation/Anatomy
& Cell Biology
University of Florida

I can’t tell you how disappointed I am to see my Academy wade into the murky waters of social engineering. I refer to the fatuous notion of diversity, which to those not benumbed by political correctness, is nothing more than a code word for racial quotas. Fortunately, some members (Drs. Nussdorf and Rohan) have retained their common sense, as opposed—apparently—to some members of the AAOS leadership. The AAOS does a fine job of representing the interests of orthopaedic surgeons and promoting orthopaedic education. It should stick to that job. Ironically, none of this may matter, as the malpractice premium juggernaut is going to drive us all from the field, and nobody in their right mind will want to go into the medical profession. Now there is an effort the AAOS should put its prestige behind, and I know it is.

Richard A. Hurd, Jr., MD
Alpharetta, Ga.

I read with interest the letter from Michael Rohan, MD, as well as the excerpts from Dr. Augustus White’s parting remarks to the AAOS Board of Directors (April 2002). I had the pleasure of meeting Dr.White shortly after his return from Vietnam when he visited the hospital where I was a resident. Dr. White’s points are well taken, but seem to have a passion for the African- American minority and rightly so, he being one himself.

I want to speak out for the Asian Indian community of orthopaedic surgeons. Affirmative action is an unknown for us. I can tell you that from my personal experience when seeking a residency in orthopaedics. The story has been repeated in countless instances I have known. At least two of my contemporaries, titans in their chosen orthopaedic subspecialty, were conveniently omitted from holding high posts — in the subspecialty association in the case of one and denied the chairs of departments in the case of both.

Asian-Indians find no solace when it comes to post-residency fellowships either; many have to settle for non-accredited posts or none at all. This week I read about a Democratic Iraq. The writer concluded that Iraqis have no experience with democracy because the country was cobbled together by the British after World War I, only to be shaken by internal strife from the very heterogeneous population. It reminded me a whole lot about the AAOS with its diversity of members, by race, religion and color.

The largest contribution to the OREF came from a naturalized citizen born in India. I am certain the color of that donation looked green to all that beheld it. Is it not time that the AAOS applies the preamble ideals of the Declaration of Independence, so aptly included in Dr. White’s parting speech, remembering that the Academy now is home to many naturalized Americans and their children from all parts of the globe.

S. Gopal Krishnan, MD
Weslaco, Texas

This is in regards to a letter from David A. Thull, MD, regarding your 2002 Orthopaedic Census showing that female orthopaedic surgeons earn less money than males (April 2003). I don’t have a problem with that statement, because I do agree that some female orthopaedic surgeons do indeed work fewer hours and take less call, but I take offense to the fact that he noted that female orthopaedic surgeons "routinely work fewer hours and take less call." I am part of a four "man" group and trust me, I take call on a routine basis the same as my male counterparts and I certainly routinely work the same amount of hours, if not more hours. So I think that he needs to readjust his premise as well.

Mary Beth Cermak, MD
Erie, Penn.

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